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Autofluorescence and Indocyanine Green in Thyroid Surgery: A Systematic Review and Meta-Analysis
Diego Barbieri1, Pietro Indelicato1,2, Alessandro Vinciguerra1,2
1Division of Head and Neck department, Otorhinolaryngology unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Objectives/Hypothesis:
To estimate the impact of optical techniques on prevention of post-operative hypocalcemia and hypoparathyroidism after total thyroidectomy.
Study Design:
Systematic review and meta-analysis.
Methods:
A literature search was conducted in Pubmed, EMBASE, SCOPUS, and Cochrane databases. The main inclusion criteria for eligible articles for meta-analysis were patients with benign or malignant thyroid pathologies who underwent total thyroidectomy, utilization of optical techniques to support PGs preservation, the availability of calcium and/or PTH levels. The primary outcome was to evaluate the variation of calcium and PTH levels when adopting optical technologies compared to standard naked-eye surgery.
Results:
In total, 13 papers with 1484 procedures were included. Pooled proportion for short- and medium-term hypocalcemia rates were 8% (95% CI, 5%:11%) and 1% (95% CI, 0%:4%) for optical techniques, while for naked-eye surgery were 15% (95% CI, 9%:23%) and 5% (95% CI, 2%:9%), respectively.
Conclusions:
Optical technologies reduced short and medium term hypocalcemia compared to conventional surgery.
Level Of Evidence:
NA Laryngoscope, 131:1683-1692, 2021.
